Liposomal Nasal Spray versus Guideline-Recommended Steroid Nasal Spray in Patients with Chronic Rhinosinusitis: A Comparison of Tolerability and Quality of Life
Objective. To investigate the tolerability and impact on quality of life of liposomal nasal spray compared to guideline-recommended steroid-based therapy in patients with chronic rhinosinusitis. Symptom reduction and use of antisymptomatic medication were also examined. Methods. In this monocenter, prospective, controlled, open, and noninterventional study, 60 patients with chronic rhinosinusitis were treated with liposomal nasal spray and 30 patients received steroid-based therapy. The study comprised five visits occurring at intervals of two to four weeks. Efficacy was determined according to the sinusitis symptom score documented daily. The polyp score was recorded at the initial and final visits. Tolerability was determined through the Nasal Spray Evaluation Questionnaire, and quality of life was ascertained with the SNOT-20 Score. Results. Both treatments achieved a significant reduction of sinusitis symptoms ( ) and also rhinoscopic improvement ( ). The majority of patients assessed the treatments as “good” or “very good,” and the quality of life improved significantly ( ). There was no significant difference in symptom reduction, QoL, and endoscopic exams between both treatments. Conclusion. The treatment of chronic rhinosinusitis with liposomal nasal spray results in a similar, significant reduction of symptoms and significant improvement in quality of life as guideline-recommended treatment and is therefore a comparable alternative. 1. Introduction With a lifetime prevalence of about 5%, chronic rhinosinusitis (CRS) is one of the most frequently occurring chronic disorders worldwide [1, 2]. The German, European, and US-AWMF guidelines recommend as treatment the topical application of glucocorticoids since they represent an important treatment principle in addition to antibiotic treatment in conservative therapy [2, 3]. Nasal irrigation or sprays with hypertonic buffered solutions can also provide symptom relief in CRS disorders and are therefore recommended by guidelines. These sprays improve mucociliary clearance by liquefying nasal secretion and have been observed to have vasoconstrictive and decongestant effects [4]. Treatment alternatives should be pointed out to patients who have a critical view of guideline-recommended steroid-based therapy. One such alternative therapy concept is the nasal application of (phospholipid) liposomes. Several studies have already demonstrated the efficacy of this nonpharmacological mechanism of action in allergic rhinitis [5, 6]. Three precursor studies which investigated the application of a liposomal nasal
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